Invention Disclosure Form

If you believe that your invention may be protectable, then you should prepare a disclosure of the invention in written form. Your disclosure should indicate what your invention is, how it works, how it can be used, and how it is an improvement over known articles or methods. Preferably, your disclosure information should include one or more drawings of your invention, and your written description should also make reference to your drawings as appropriate.

Your disclosure should be signed and dated by you and witnessed by at least two individuals who are not coinventors.

It is also recommended that you maintain a diary or laboratory notebook to keep track of the dates when you initially conceived your invention and the steps taken to reduce it to practice.

PATENT APPLICATION WORKSHEET To better enable us to assist you in obtaining patent protection, please carefully consider the following questions and provide thoughtful answers. The detail of information provided in response to these questions can prevent costly modifications later. Please carry your answers onto a separate sheet of paper if necessary. 1. Briefly describe the problem that you were trying to solve? How did you discover that a problem existed? Describe the general nature of the problem. Is it electrical, mechanical, thermal, wasteful of resources, costly, etc.? If the answer is costly -explain why the problem is costly! Are there any publications which discuss the problem? If so, please attach a copy. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________ 2. What solutions were used to solve this problem in the past? It must be recognized that there are no truly perfect solutions to any problem! A corollary to this hypothesis is that every problem has been solved in some way. One possible solution which may have existed prior to your invention was to ignore the problem all together. Describe all of the solutions that come to mind which have been and are now being used to solve the problem. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________ 3. What was it about each of these solutions that failed to solve this problem? __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ 4. Describe your solution. If you have adequately defined your problem above, please state your solution to the problem. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ 5. Depict your solution using as many drawings as necessary. It has been said that a picture paints a thousand words. That is certainly true in a patent application. Each element of your invention should be depicted in as many views as necessary to be understood. If appropriate, include photographs. The entire invention, including each element, should also be depicted so that any interaction between the elements is apparent. Do not worry about artistic skills -simply attempt to get your point across – better drawings can be done later. 6. Referring to the drawings, describe in detail how your solution works. Describe each and every physical or functional element, focusing on how the elements interact with each other to solve the problem described in question 1. You must provide enough detail to enable another person working on the same problem to duplicate your solution. You must provide this level of detail on the specific embodiment or version that you consider to be the best solution to the problem. However, other "less perfect" versions can also be described. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ 7. Describe the functional and structural differences between your solution and the prior solutions. One requirement necessary to be granted a patent is that your invention must be new or "novel", that is, it must be structurally different from any of the prior solutions. The more your solution differs from the prior solutions, the more likely it is that your invention is novel. Select the most important structural differences and discuss what is different about them both in terms of structure and function. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ 8. Describe all of the reasons why your solution would NOT be obvious to another inventor working on the same problem at the same time. Another requirement necessary to be granted a patent is that your invention be "non-obvious". Why isn't your solution an obvious combination of the previous solutions? __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ 9. Describe all of the results achieved by your solution. What happened when you used your solution to solve the problem? What other ancillary results were achieved not directly related to the problem? Attach and explain all hard data supporting your position if possible (numerical values, graphs, curves, plots, charts, etc.) Describe all other results such as "worked better", "saved money", or "made customer happy." Also, give sales results, if available, or any other evidence of commercial success. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ 10. Describe all of the advantages of your solution over the prior solutions. Compare your solution to the prior solutions and describe the advantages of using your solution over the prior solutions. List every advantage you can think of, including those not directly related to the problem. Include analytical results, documentation, or other evidence if possible. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ To ensure that we have all information necessary to represent you as expeditiously as possible, please complete the following table: Full Name: ___________________________ Fax Number: ___________________________ Address: ___________________________ E-Mail Address: ___________________________ City/State/Zip: ___________________________ Citizenship: ___________________________ Day Phone: ___________________________ Date of Birth: ___________________________ Evening Phone: ___________________________ Occupation: ___________________________ STATEMENT OF CONFIDENTIALITY AND NON-USE The firm of Kristina M. Grasso, Esq. PLLC, its employees and agents, hereby agree to respect the confidentiality of, and keep secret, all information submitted to the firm, including inventions, ideas, and/or product concepts, as well as all personal information, and further agrees not to disclose any information without discloser’s prior written permission. The sole exception to this agreement shall apply to such disclosures that the firm may have to make to comply with the governing law.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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